An Act to create provisions for the Psychiatric Collaborative Care Model to be reimbursable for insurance.

Be it enacted by the Legislature of the State of South Dakota:

Section 1. That chapter 58-17 be amended with a NEW SECTION:

Any health insurer offering any individual or group health insurance policy, contract, certificate, or plan delivered, issued for delivery, or renewed in South Dakota on or after January 1, 2024, and mental health or substance use disorder benefits, except for policies that provide coverage for specified disease or other limited benefit coverage, shall provide reimbursement for such benefits that are delivered through the Psychiatric Collaborative Care Model.

The benefit and reimbursement requirements of this section shall not apply to any policy, contract, or service that would require the state to defray the cost as specified in 42 U.S.C. § 18031(d)(3)(B)(ii), as amended and in effect on January 1, 2023.

For purposes of this section, the term, health insurer, is defined as provided in § 58-17-100.

For purposes of this section, the term, Psychiatric Collaborative Care Model, means an evidence-based, integrated mental health service delivery method that is provided and directed by a primary care team consisting of a primary care provider and a care manager, who provide structured care management and regular assessment of a patient's clinical status using validated tools and treatment modification as appropriate, and a psychiatric consultant, who provides regular consultations to the primary care provider and care manager to review the clinical status and care of the patient and to make recommendations for continued care.